Javier's Computer Repair

Digital Intake & Repair Authorization
STEP 1

Customer Information

At least one contact method (phone or email) is required.

Device Information

STEP 2

Device Condition at Intake

Useful for documenting pre-existing cosmetic damage. Photos are stored with the local record if you complete the intake.

Data Backup & Login Access

Temporary session-only field. It is intentionally excluded from all saved records and exports.
STEP 3

Repair Authorization

$
$
Existing condition notice: If the device cannot be fully tested at intake, hidden or additional issues may be discovered after the original problem is corrected. Estimates may change if additional issues, part failures, or data-recovery needs are found.
STEP 4

Service Terms, Privacy Notice & Data Consent

1. Diagnostic & Repair Authorization

I authorize Javier's Computer Repair to inspect, test, disassemble, diagnose, and repair the device listed on this intake as reasonably necessary to address the reported issue.

2. Backup Recommendation & Risk of Data Loss

I understand I am responsible for backing up my data before service. Repairs involving storage devices, operating systems, malware removal, software repair, hardware failure, or data recovery may result in data loss or corruption.

3. Privacy & Limited Data Access

Technicians will make reasonable efforts to avoid accessing personal files unless access is necessary to diagnose or verify a repair. Personal information will not be intentionally copied or shared except as required to perform service or by law.

4. Passwords & Accounts

Providing a password is optional. If I provide passwords, PINs, or account access for service, I authorize their use only for the purpose of servicing the device. I understand I should change those credentials after service is completed.

5. Existing Condition & Hidden Defects

If a device arrives non-functional, password-locked, damaged, or otherwise unable to be fully tested, Javier's Computer Repair cannot verify the condition of all components at intake. Additional issues may be discovered later, including pre-existing damage or failures unrelated to the original complaint.

6. Estimates, Parts, & Additional Work

Any estimate is based on the information available at intake. If additional parts, labor, or services are required, the customer will be contacted when approval is needed according to the authorization preferences on the intake.

7. Specialized / Third-Party Repair

If specialized repair, board-level repair, or off-site service is needed, the device may be transferred to an authorized third-party repair resource. The customer will be notified when practical before this occurs.

8. Pickup, Storage, & Unclaimed Equipment

Completed devices should be picked up promptly. Unclaimed devices may be subject to storage fees and, after reasonable notice and any applicable waiting period required by law, may be disposed of or otherwise handled as permitted by law to recover unpaid balances.

9. Limited Service Warranty

Unless otherwise stated in writing, labor performed by Javier's Computer Repair is covered for the stated warranty period on the final invoice. Warranty coverage does not apply to unrelated failures, accidental damage, software misuse, liquid damage, power surges, or customer-supplied parts unless agreed in writing.

STEP 5

Signatures

Sign with mouse, finger, or stylus
By signing, the customer confirms the intake information and accepts the selected service terms and data consent choices.
Technician signature
STEP 6

Review Intake

Customer signatureCustomer signature
Technician signatureTechnician signature
Local app behavior: completed records are saved in this browser's local IndexedDB. The device login/PIN/password is never saved. For multi-device access, automated email, cloud backup, or staff logins, deploy this front end with a secure backend or Microsoft 365 workflow.
LOCAL RECORDS

Completed Intakes

Search, reopen, print, export, or delete records stored on this device.

0Total Records
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Work OrderDateCustomerDeviceContactActions